Commonwealth of Pennsylvania
Department of General Services
To:
Equipment Number
OLD CODING / NON-SAP: BA # (DEPT #)
Coding Change
Part II - DRIVER'S INFORMATION
Vehicle Operator
Executive Vehicle
Location Change
Executive Driver
Zip Code Work
Zip Code Work
Part III - LICENSE / REGISTRATION / PLATE REQUESTS / INSURANCE CARD / WEIGHT CLASS STICKER
Signature (Automotive Liaison)
Date
Org #
Confidential or PA to
Fictitious
___Confidential or ___PA
Plate
Request for Duplicate
____ Registration ____ Sticker
Replacement of Defaced
Credit Card
Vehicle Day Time Location:
License Number
Address
Operator's Job Title
County Name
Did Driver transfer from another agency? ________Yes ________No
Driver
NEW SAP CODING
Internal Order
NEW CREDIT CARD
ACCT #
Cost Center
NEW CODING/NON-SAP : BA# (DEPT #)
License Plate Number
Org #
OLD SAP CODING Fund
(Last Name)
Other
_____________________
Driver's Name
Home
Assignment of License Plate (Attach Form
GSVM-95 for Confidential License Plate).
Vehicle Overnight Location:
Vehicle
Address
Defaced License Plate. Issue New Plate to
Replace Plate Number.
County Name
Home
VEHICLE INVENTORY CHANGE REPORT
Vehicle Administration Division
Bureau of Vehicle Management
OLD CREDIT CARD
ACCT #
Replacement of
Lost/Stolen Credit Card
(Department, Board or Commission)
Internal Order
Insurance Card
Duplicate Weight
Class Sticker #
PA
VEHICLE ADMINISTRATION USE ONLY
PA to Confidential
New License Plate Number
If yes, what Agency